Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1-148726 | AL |
N | 363LG0600X | Nurse Practitioner - Gerontology | 1-148726 | AL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 1-148726 | AL |
N | 363LW0102X | Nurse Practitioner - Women's Health | 1-148726 | AL |
NPI | 1063986347 |
---|---|
Provider Name | Mrs. Melayna Lynn Amison |
First Address | Birmingham, AL 35215-3018 |
Second Address | Birmingham, AL 35242-0302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2019 |
Last Update Date | 19/01/2019 |